Hip Pain:

There are a variety of causes of hip pain in infants, children and teens, these include  age, family history, birth injury, traumatic injury, overuse, infection or tumor growth.
 

Symptoms:

Signs of hip pain will present in different ways dependent on age and reason for pain. 
With an infant/toddler it may be apparent when changing a diaper or clothing.  Young child may be fussy, cry or withdraw when moved, eat poorly or have difficulty sleeping.
An older toddler or child may refuse to walk or crawl. Teens may limp and have difficulty with stairs or squatting to the floor. The older child or adolescent may describe the pain as sore, sharp, needs to pop, clicking/snapping sound, or tender when you touch their hip.  Sometimes the child/adolescent may actually complain their knee, thigh or groin area is sore.  Pain that wakes the child up at night can be concerning. 
 

Evaluation:

An evaluation by a Primary Care Physician (PCP) is the first step to care. The physician will arrange for further tests if needed; these may be X-rays, CT Scan, MRI or blood work. The physician may also refer to a specialist based on the exam and results of tests. Most often the specialist will be an orthopedic physician. 
The physical therapist evaluating your child will review the reports from the Primary Care Physician and Specialist. She will also review diagnostic testing including X-rays, MRI, CT scan or blood work done by your doctor. You will need to bring the prescription and copies of reports to the evaluation. You do not need to bring in the X-rays. Please any written precautions your doctor has prescribed, such as no running or jumping. Please have your child dressed in clothing they can easily move in.  This will allow the therapist to exam and observe your child. The therapist discuss with you your child’s medical history including past medical diagnoses, injuries or traumatic events, family medical history and any recent injury or new diagnoses.  We will discuss in detail how the pain is affecting your child with sleep, participation in school and other activities. The physical examination of your child  will include measurements of how well your child can move his legs, arms, neck and back.   The therapist will also test your child’s strength, coordination, balance and endurance.  She will watch your child walk and perform typical movements.  Specialty tests may include measuring leg length, feeling muscles and bones around painful areas, testing reflexes and testing how well your child can feel his arms and legs. At the end of the physical exam the therapist will discuss the results with you. The therapist will talk with you to determine a therapy plan.  This will include how often your child will be seen and for how long.  Sometimes after the exam it is necessary to send your child back to the referring physician for further testing. 
 

Treatment:

There are many treatment methods for hip pain depending on the age of the child and the reasons for the pain.
Your physical therapist will teach you and your child some ideas on how to help your child feel better and improve his mobility. It is important to follow through with these suggestions to make progress.  It is also important to talk to your therapist if the pain is not improving or getting worse. 
Some of these methods include stretching, strengthening, balance and coordination training, endurance training, postural awareness education, positioning for better sleep, and relaxation/pain management strategies. 
 

Knee Pain:

Knee pain in a child or adolescent can occur due to many reasons.  Many times the reasons for pain can be related to type of activity/sport being played, age and even gender.
 

Symptoms: 

Signs of knee pain will present in different ways.  The pain may be described as feeling as though the knee is stuck, stiff, pops/crackles or gives way when taking a step.  It may also be difficult to bend or straighten the knee with full motion. The knee could be tender or warm to touch and have swelling Depending on the reasons for pain the child may either limp or refuse to walk or have difficulty going up and down the stairs or getting up and down from the floor. Most often the pain is only in one leg. Pain that wakes the child/adolescent up can be more concerning.
 

Evaluation:

An evaluation by a Primary Care Physician (PCP) is the first step to care. The physician will arrange for further tests if needed; these may be X-rays, CT Scan, MRI or blood work. The physician may also refer to a specialist based on the exam and results of tests. Most often the specialist will be an orthopedic physician.  

The  physical therapist evaluation  includes a review of reports from the Primary Care Physician and Specialist and a review of diagnostic testing including X-rays, MRI, CT scan or blood work done by your doctor. Please bring the prescription and copies of reports to the evaluation. You do not need to bring in the X-rays. Please bring any precautions your doctor has prescribed, such as no running or jumping. Please have your child dressed in clothing they can easily move in.  This will allow the therapist to exam and observe your child. The therapist will talk with you about your child’s medical history including past medical diagnoses, injuries or traumatic events and your child activities. It is necessary to know details on how the pain is affecting your child with sleep, participation in school and other activities. The therapists examination will include measurements of how well your child can move his legs, arms, neck and back.   The therapist will also test your child’s strength, coordination, balance and endurance. She will watch your child walk and perform typical movements.  Specialty tests may include measuring leg length, feeling muscles and bones around painful areas, testing reflexes and testing how well your child can feel his arms and legs. At the end of the physical examination, the therapist will discuss the results. The therapist will talk to you to determine a therapy plan.  This will include how often your child will be seen and for how long.  Sometimes after the exam it is necessary to send your child back to the referring physician for further testing.   

Treatment:

There are many treatment methods for knee pain depending on the age of the child and the reasons for the pain. Your physical therapist will teach you and your child some ideas on how to help your child feel better and improve his mobility. It is important to follow through with these suggestions to make progress.  It is also important to talk to your therapist if the pain is not improving or getting worse. It is also very important to follow directions of precautions prescribed such as rest, no running or jumping and breaks from sports.  The body needs time for recovery for specific injuries in order to prevent future injuries.  Some of the treatment methods include stretching, strengthening, balance and coordination training, endurance training, postural awareness education and relaxation/pain management strategies. 

 
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